Inspection on 01/06/05 for Langdon House

This inspection was carried out on 1st June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Langdon House 16/10/07

Langdon House 26/07/06

Langdon House 01/11/05

Langdon House 17/11/04

Langdon House 27/07/04

Langdon House 18/02/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Langdon House 1 Scotland Road Cambridge CB4 1QE Lead Inspector Janie Buchanan Announced 01 June 2005 @ 09:00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Langdon House Version 1.10 Page 3 SERVICE INFORMATION Name of service Langdon House Address 1 Scotland Rd, Cambridge CB4 1QE Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01223 578601 01223 578629 Cambridge Housing Society Ltd Susan Gooch Care Home 47 Category(ies) of Dementia- over 65 years (11), Old age, not registration, with number falling within any other category (47) of places Langdon House Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: Not applicable Date of last inspection 17 November 2004 Brief Description of the Service: Langdon House is a purpose built home owned and run by Cambridge Housing Society. It provides accommodation and personal care for 47 older people. This includes a specialist unit for the care of 11 people with one of the dementias. The home is in walking distance of local amenities and is a short drive away from Cambridge City Centre. All bedrooms are spacious and have ensuite facilities. The residents have a choice of bright airy communal rooms and also access to a newly landscaped garden. Accommodation is on two floors with the upper floor being accessed by a passenger lift. Langdon House Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was the home’s first inspection for the year 2005/6. It was announced. The inspector spent 7.5 hours at the home and talked with 6 residents, one visiting relative, 5 members of staff and the manager. The inspector also lunched on the dementia care unit and chatted informally to many of the residents there whilst observing staff help residents with their lunch. She undertook a brief tour of the home and viewed a range of documents. The inspector also received a total of 43 completed comment cards from both residents and their relatives. The majority of respondents expressed satisfaction with the quality of care, staffing, activities and food provided at Langdon House. However, eight of these respondents stated that they would not know who to talk to if they were unhappy with their care; two requested better communication from staff about their relatives’ illnesses; two complained about the cleanliness of the bathrooms; one resident requested more contact with the home’s ‘governors’ and another requested that staff wear name badges. These issues were discussed with the manager. Two additional visits conducted by the pharmacy inspector have been made in a response to a complaint since the last unannounced inspection and letters sent to the manager following those visits can be obtained from the CSCI office on request. What the service does well: What has improved since the last inspection? There have been improvements in the home’s medication storage and administration procedures since the last inspection. A lockable fridge has been purchased to store those medicines that require refrigeration, stock levels of Langdon House Version 1.10 Page 6 medication are now regularly reviewed, staff’s competency to administer medication is assessed, and risk assessments are in place for those residents who wish to self medicate. The frequency of supervision has increased, giving staff members the opportunity to meet with their line manager to discuss aspects of their practice and training needs What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Langdon House Version 1.10 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Langdon House Version 1.10 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4,5 Information available about the home is excellent, allowing prospective residents to make a fully informed choice about whether or not the home is suitable for them. Admission procedures are also good, ensuring that staff can fully meet residents’ needs. EVIDENCE: The home has a detailed statement of purpose and service user guide that is widely available to residents. This information is available in an audiotape that the inspector has listened to on previous occasions. A brochure about the home is also issued to prospective residents when they request an initial application form to live at the home. Pre-admission visits to the home are encouraged and one relative told the inspector that he, his mother and a number of family members had visited the home several times before his mother decided to move in. The manager has plans to make a video of life in the home that could be shown to prospective residents: the inspector would welcome this development. Langdon House Version 1.10 Page 9 The inspector viewed 3 residents’ files and each contained a comprehensive pre-admission assessment completed by a senior staff member and a ‘Licence to Occupy Residential Accommodation’. Langdon House Version 1.10 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,9,10,11 Individual plans of care are available but little progress has been made on the requirement to ensure that residents’ needs are actively reviewed monthly. Personal support in the home is offered in a way that promotes and protects residents’ privacy and dignity. EVIDENCE: The manager stated that the key worker sits down with every resident each month to actively review their needs, and update their plan of care. However, of the four plans that the inspector viewed, none had been reviewed monthly as required by this standard (two of the plans had not been reviewed in more than a year) and there was little evidence of resident participation in that review. Information in the plans was basic and some was not up to date. It was often unclear when information had been recorded, or who had recorded it. Many of these issues were pointed out at the last inspection and it was disappointing to note that there had been little improvement. Almost all of the respondents to the comments cards stated that they felt staff respected their privacy and dignity and residents further confirmed this on the day of inspection. The home has policies and procedures in place for handling death and dying and residents’ terminal care wishes were clearly recorded in Langdon House Version 1.10 Page 11 their care plans. In a recent unexpected death at the home, counsellors were quickly arranged to support both staff and residents: this practice is to be commended. Langdon House Version 1.10 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,15 Social activities and meals are both well managed and provide variation and interest for people living in the home. EVIDENCE: There are regular planned activities each week at the home: every Friday there is a music and movement class; Sundays a church service; Tuesdays and Wednesdays a discussion group led by a representative from the University of the 3rd Age (U3A) and a knitting group is held every other Saturday. In addition to this there are a number of additional activities. On 3rd May a drama group visited the home, 3 residents attended a concert at St Mary’s church on 19th May and a number of residents attended the Camsight coffee morning. Two residents also attend a regular art class. A trip to Hunstanton has been planned for the 27 July and the manager stated she hopes to arrange regular pub outings for residents now that the weather is better. One resident told the inspector that, although she did not attend every week, she greatly enjoyed the U3A discussion groups. The inspector had lunch with residents on the dementia care unit and was particularly impressed at the pleasant surroundings (enhanced by residents’ artwork on the walls); the relaxed and calm atmosphere; the choice of food offered to residents; the quality of interaction between staff and residents; and Langdon House Version 1.10 Page 13 the discreet and sensitive way in which residents were helped to feed themselves. The food was tasty and nutritious. Langdon House Version 1.10 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,17,18 The home’s has a comprehensive complaints procedure in place however it should be more widely available to residents so that they know how complaints may be made and who will deal with them. Residents’ rights to participate in the political process are upheld. EVIDENCE: Details of how to complain are included in the Service User Guide, the home’s Statement of Purpose and the complaints procedure. This is also displayed on the notice board in the main entrance. Despite this, not all residents were aware of how to lodge a complaint or who would deal with them. In light of this the manager agreed to reissue residents with a copy of the complaints procedure, in an accessible format to them. The home has received a total of 10 complaints in the last year. Of these two (concerning medication and the cleanliness of a bathroom) have been substantiated. The manager of the home had responded appropriately to all these complaints. The Commission for Social Care Inspection has also received a number of complaints, concerning medication and the home’s recent staff restructuring. These have been fully investigated by the Commission and as a result a number of requirements were made (and have now been met) regarding medication procedures in the home. The manager stated that all but four residents voted, mainly by post, in the recent general election. 80 of staff have attended training in the protection of vulnerable adults and staff talked knowledgeably about this issue. Langdon House Version 1.10 Page 15 Langdon House Version 1.10 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,22,23, Residents live in a pleasant, comfortable, safe and well-maintained environment with sufficient aids and adaptations in place to maximise their independence. EVIDENCE: Langdon House is a purpose built home for older people. It provides a range of aids and adaptations to meet the needs of disabled people such as grab rails, mobile hoists, bath chairs, raised toilet seats, widened doors and a loop system (for the hearing impaired). The home is divided into four separate units and each has its own sizeable sitting room and dining area. In addition to this, there is a large seating area that overlooks the garden and smaller seating areas dotted around the home. There is no separate smoking area but residents are allowed to smoke in their own bedrooms or in the garden. There is also additional office space that can be made available to residents if required. All areas within the home are accessible to wheelchairs users. The inspector observed the home to be well maintained, clean and in good decorative order. The grounds surrounding the home were tidy, safe and attractive. All bedrooms are in excess of the national minimum size Langdon House Version 1.10 Page 17 requirements and have ensuite facilities. The home has been experiencing continued problems with its hot water supply. Water temperatures are unpredictable and fluctuate from one area of the home to another. Although Cambridge Housing Society Ltd have worked hard to try resolve these problems it has taken well over a year. The manager stated that upgraded mixer valves were currently being installed in all water outlets and that this, she hoped, would stabilise water temperatures throughout the home. Langdon House Version 1.10 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29,30 Residents are looked after by trained and competent care staff. The home’s recruitment and selection procedures are robust and ensure that residents receive care from staff who have been properly vetted. EVIDENCE: Staffing levels are satisfactory and there are sufficient staff on duty to meet the needs of residents. Residents interviewed by the inspector felt confident that staff would respond quickly if needed. Staff turnover is low, although the home does rely heavily on agency staff to cover 4 staff who are currently on long-term sickness leave and two who are on maternity leave. 85 of care staff have achieved their NVQ Level 2 in care: this number is excellent and is well above the level required by the minimum standards. Domestic and kitchen staff are about to undertake relevant NVQs in cleaning and catering. The inspector checked the training records for 3 members of staff which showed that they had received all mandatory training. The inspector interviewed a recently employed member of staff. This staff member confirmed that she completed an application form for her post, was interviewed by 3 people, undertook a competency test, and did not start her job until satisfactory references and CRB checks had been undertaken. She stated that her recruitment had been fair and thorough. Langdon House Version 1.10 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,36,38 Residents receive a consistent and well-managed service and their views are actively sought. However, some moving and handling practices in the home are poor, putting both the carer and resident at risk of injury. EVIDENCE: The manager of the home is competent and experienced to run the home and the inspector has been impressed by the speed and thoroughness in which she responds to any issues that she has been asked to investigate. The inspector received many positive comments from both staff and residents about her approachability, patience and commitment to residents. Feedback about the home’s performance is regularly sought from residents, visitors and staff. Cambridge Housing Society Ltd has recently introduced a new management structure, working arrangements and pay scales for staff at Langdon House. Although these changes have resulted in one member of staff being made redundant and two staff who are yet to agree to their new contracts, staff morale was good on the day of inspection. Staff reported that they had been Langdon House Version 1.10 Page 20 fully consulted about the proposed changes and one stated ‘introducing a career structure is a really good motivation for staff’. The inspector witnessed one care assistant struggling by herself to transfer a resident from her wheelchair to a seat. When the inspector subsequently checked this resident’s moving and handling risk assessment it clearly stated that two carers were required for all transfers. Langdon House Version 1.10 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 x x 3 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 3 3 x x 3 x 2 Langdon House Version 1.10 Page 22 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard 7 38 Regulation 15(b) 13(5) Timescale for action Residents care plans must be Immediate regularly reviewed. and ongoing The registered person must Immediate ensure that staff follow residents and moving and handling risk ongoing assessments. Requirement RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 16 Good Practice Recommendations A copy of the complaints procedure should be reissued to each resident Langdon House Version 1.10 Page 23 Commission for Social Care Inspection CPC1, Capital Park Fulbourn Cambridge CB1 5XE National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Langdon House Version 1.10 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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